This scoping review identified a large body of knowledge exploring the factors and interventions associated with the quality of life of people with dementia. The interventions were heterogeneous and the sample sizes small, which is why more research is needed.

Evidence-based practices (EBPs) seek to promote the implementation of interventions that are effective, appropriate, feasible and meaningful for patients. The current demand for updated EBPs in Finland is shaped by national legislation. This study's aim was to describe nurses' , nurse directors' and clinical nurse specialists' (CNSs') perceptions of how well EBPs are being implemented in nursing in Finland. Methods:In this quantitative descriptive study, the data were collected with an e-questionnaire distributed in Finland in 2017 and analysed using descriptive statistical methods.Results: A total of 1063 nurses and 340 nurse directors and CNSs participated. The majority of nurses (64%, n ¼ 669) reported that evidence is not clearly used to develop clinical practices. Most nurses (67%, n ¼ 702) and over half of nurse directors and CNSs (57%, n ¼ 184) also observed that knowledge of evidence-based protocols is not widespread within their organizations. However, 39% of nurses (n ¼ 407) and 53% of nurse directors and CNSs (n ¼ 171) stated that they are developing EBPs. Conclusion:The results indicate that nurses need more support to implement EBPs.

Objective: To find out how regularly the contents of patient education regarded as essential for COPD patients' self-management are provided by healthcare professionals in specialised healthcare (SHC) and primary healthcare (PHC) in Finland. Design: A cross-sectional study based on an e-questionnaire with 42 items on the content of self-management education of COPD patients. Setting: The study sample included all public SHC units with pulmonary outpatient clinics (n ¼ 29) and nine out of 160 health centres in Finland. Subjects: 83 doctors and 162 nurses. Main outcome measures: The respondents' answers on how regularly they included the contents regarded as essential for COPD patients' self-management in their education of COPD patients. Results: COPD patients were educated regularly on medical issues regarding COPD treatment, such as smoking cessation, exercise and pharmacological treatment. However, issues vital for coping with the disease, such as psychological well-being, stress management or fatigue, were often ignored. Patient education in SHC seemed to be more systematic than education in PHC. The education provided by the asthma/COPD nurses (n ¼ 70) was more systematic than the education provided by the other nurses (n ¼ 84). Conclusion: Healthcare professionals' continuous education should cover not only the medical but also the psychosocial aspects of coping with COPD. The role of doctors and nurses should be considered to ensure that there is no gap in COPD patients' education. Training asthma/COPD nurses and promoting specialised nurse-led asthma/COPD clinics in primary care could be beneficial while improving practices of patient education that enhance patients' ability to cope with the disease. KEY POINTS Issues vital for coping with chronic obstructive pulmonary disease (COPD), such as psychological well-being, stress and fatigue, are irregularly included in self-management education both in primary and specialised healthcare. Patient education provided by asthma/COPD nurses is more regular than patient education provided by other nurses. The distribution of work between doctors and nurses should be considered to ensure that there is no gap in COPD patients' education.

Objective: The objective of this review was to identify and synthesize existing evidence on the experiences and expectations of self-management counseling of adult family members who are informal caregivers of a person with chronic obstructive pulmonary disease (COPD) in the context of inpatient or outpatient care. Introduction: Chronic obstructive pulmonary disease is the fourth leading cause of mortality and morbidity worldwide. It is a progressive, lifelong and unpredictable disease. As the disease progresses, both the people with COPD and their family members require information and practical skills to manage the disease. The role of family members is particularly important at the advanced stage of COPD. This systematic review examined family members’ experiences and expectations of self-management counseling. Inclusion criteria: This review considered qualitative studies that investigated adult (older than18 years) family members’ experiences or expectations of COPD self-management counseling in the context of inpatient or outpatient care. “Family member” refers to a person who is an informal caregiver because of his or her relationship to the person with COPD. Methods: A three-step search strategy was utilized in this review. The search strategy aimed to find published and unpublished studies in English and Finnish. The databases MEDLINE, CINAHL, PsycINFO, Scopus and the Finnish medical bibliographic database, Medic, were searched. The search was conducted in December 2015 and updated in September 2018. Titles and abstracts were screened by two independent reviewers for the review's inclusion criteria. Eligible studies were then critically appraised by two independent reviewers for methodological quality. The findings and illustrations of the findings were extracted and assigned a level of credibility. The qualitative research findings were pooled using the JBI method of meta-aggregation. Results: Ten papers were selected for inclusion in this review. These studies were published from 2002 to 2017. The quality of all included studies was at least moderate. Each study had a total score between 7 and 10 on the JBI Critical Appraisal Checklist for Qualitative Research. The following four synthesized findings were aggregated from nine categories and 39 study findings: i) Family members’ experiences with unresponsive behavior from health professionals, ii) Family members’ experiences of unmet needs in self-management counseling, iii) Family members’ information needs concerning COPD management, and iv) Family members’ information needs concerning coping strategies. Conclusions: The synthesized findings indicate that family members are frustrated by the shortcomings of self-management counseling. They also feel unprepared for and uncertain about their caring role. They need more information about COPD and coping strategies for COPD. Counseling is essential to high-quality care and should be offered to family members caring for a loved one at any stage of COPD.

Chronic obstructive pulmonary disease (COPD) is a persistent, life-limiting disease and is currently the fourth leading cause of death in the world (GOLD, 2020). Although COPD is incurable, its symptoms can be relieved and the quality of life of those with COPD can be improved. Because self-management is a crucial part of the lives of people with COPD, they need the requisite knowledge and skills to cope with this task. The disease's trajectory as well as the life situation of every person with COPD is unique. Therefore, the information needs of people with COPD vary between individuals and as such counselling provided by healthcare professionals (HCPs) should be tailored accordingly. | BACKG ROU N DCOPD is a progressive, incurable and debilitating disease. Smoking cessation is the most effective intervention to either reduce the risk of developing COPD or to stop its progression and improve long-term prognosis (GOLD, 2020). The progression of COPD can be very slow, and the symptoms can be misinterpreted as a normal

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Evidence-based healthcare (EBHC) has been recognised worldwide as important for the quality of social and healthcare services and patient care. It improves patient/client safety and decreases the variability of care, adverse events, and healthcare costs (Rudman et al., 2020). Also, the World Health Organization (WHO) has assumed that healthcare services and practices should be based on the best available evidence (WHO, 2017). Therefore, the WHO produces, for example, evidence-based guidelines and recommendations for informing global healthcare policy and practices (WHO, 2014). Systematic reviews and evidence-based clinical guidelines represent the best evidence, which is a prerequisite for the implementation of EBHC (WHO, 2017).

Introduction and aims: The aim was to explore clinical decision support (CDS) use in the practice of primary healthcare nurses. The objectives were to recognize to what extent nurses (registered nurses, public health nurses, and practical nurses) use CDS, what factors were associated with the CDS used, what kind of organizational support nurses need, and what were nurses' views about CDS development needs. Methods:The study was conducted with a cross-sectional study design, using an electronic questionnaire developed for this purpose. The questionnaire contained 14 structured questions and nine open-ended questions. The sample consisted of randomly selected primary healthcare organizations (N ¼ 19) in Finland. Quantitative data were analyzed using cross-tabulation and Pearson's chi-squared test, and qualitative data with quantification.Results: A total of 267 healthcare professionals (age range 22-63 years) volunteered to participate. Participants were mainly registered nurses, public health nurses, and practical nurses (46.8, 24, and 22.9%, respectively). Overall, 59% of the participants had never used CDS. The majority (92%) found it necessary to develop nursing-specific content for CDS. The most commonly used features were medication recommendations and warnings (74%), reminders (56%), and calculators (42%). Half of the participants (51%) had not received training on the use of CDS. The older age of participants was associated with the feeling of not having enough training to use CDS (P ¼ 0.039104). Nurses felt that CDS was helpful in their clinical work and decision-making, promoting evidencebased practice, and narrowing the research-into-practice gap, improving patient safety and the quality of care, and helping those who are new in their work. Conclusion:CDS and its support structures should be developed from a nursing perspective to achieve the full potential of CDS in nursing practice.